Provider Demographics
NPI:1346890159
Name:ALICEA BARRIERA, JESSICA (OPTICO LICENCIADO)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:ALICEA BARRIERA
Suffix:
Gender:F
Credentials:OPTICO LICENCIADO
Other - Prefix:
Other - First Name:NEW
Other - Middle Name:
Other - Last Name:ZOOM OPTICAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NEW ZOOM OPTICAL
Mailing Address - Street 1:URB PASEO DE LA CEIBA 212 CALLE ARECA
Mailing Address - Street 2:
Mailing Address - City:JUNCOS
Mailing Address - State:PR
Mailing Address - Zip Code:00777
Mailing Address - Country:US
Mailing Address - Phone:787-206-6753
Mailing Address - Fax:
Practice Address - Street 1:111 CALLE DUFRESNE W
Practice Address - Street 2:
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-3601
Practice Address - Country:US
Practice Address - Phone:787-223-5932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2023-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR1377156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician